Page:Report on the outbreak of plague at Fremantle.djvu/13

 Case IV.—R.S., age 15 (female), working as a tailoress in an infected area, but living in suburb. Sudden onset, with headache and vomiting. Bubo began to develop 24 hours after onset. Left femoral and inguinal buboes. Sharp attack for four days in hospital and termination by lysis. Rash appeared on fourth day, and affected forearms and legs. Diagnosis confirmed by smear from gland.

Case V.—P.W., age 26, living and working at a hotel, where infected rats were discovered immediately after occurrence of the case. Onset acute, with headache and vomiting. Heavy drinker for some years. Delirium active and most violent. Right femoral bubo developed in first 24 hours. No rash. Died 48 hours after onset. Diagnosis confirmed by post mortem and smears.

Case VI.— N.R., age 15 years, clerk, employed in town near an infected area, living in suburb. Onset sudden, with headache and vomiting. Left femoral bubo developed in 24 hours. Right cervical bubo developed four hours later. Pulse 120 and higher from onset. Petechial rash on forearms and wrists four days after onset. Cough with frothy, slightly blood-stained sputum four days after onset. Two patches of consolidation at base of left lung. Few bacilli found in sputum. Diagnosis confirmed by post mortem and smears.

Case VII.— V. H., age 25, employed as a nightman, working in infected areas. Vomiting at onset; right femoral bubo; rash on arms; pulse rapid; delirium active and violent. Post mortem showed usual appearances about bubo and about glands in iliac fossa; small amount of sero-fibrinous fluid in abdomen; spleen large and friable; liver enlarged and pale. Smears from glands and spleen showed bipolar bacilli in enormous numbers.

Case VIII.— J.G., age 52, was employed as a waiter at an eating-house where infected rats had been found. Left this place on February 11th. Was seen first on February 24th. Said he had been ill seven days, but as he had been drinking heavily cannot be certain. Vomiting and diarrhœa at onset; large right inguinal bubo with marked induration; highest temperature noted was 102°; no rash; bubo suppurated. Diagnosis confirmed by smears of pus showing typical bipolar bacillus.